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That just means you should be moaning even more about plants, since they require maintenance.
You can also spam posters on outer walls to increase happiness, why aren't you moaning about that? That doesn't require maintenance either.
I also find it amusing complaining about gold certs you can't even see. I for one can't see the gold certs I put on the wall behind those toilets, so how can that make the room ugly?
https://c8.alamy.com/comp/C0J27B/framed-diplomas-degrees-certificates-and-awards-earned-by-attorneys-C0J27B.jpg
Don't put Gold Awards everywhere... I prefer design my rooms independently of the prestige, I try to put other nice objects too...
Are you only going to be totally efficient 100%? I prefer to give up and make a more beautiful and creative hospital, designing each room in a unique way... avoiding even repeating objects...
That's the whole point. The way the system currently works, partially through lack of item variations also, does not allow this. Of course people should strive for the highest efficiency possible, and this therefore includes the highest prestige per room. Prestigate 5 rooms allow a bonus % to treatment and diagnostics also, based on staff happiness, if reddit posts are anything to go by.
To achieve that presently, it is (for the most part) purely based on spamming gold awards. IF you want a nicer looking hospital with more variety, prestige 5 just isn't going to happen for the most part.
As others have also mentioned, the 'attractiveness' of the hospital also plays a part in the item variety issue above mentioned, where again, you are limited to using certain items over and over again as certain items are far better than others. Also, 4 plant variations is not a huge variety.
The whole system needs a balance overhaul.
And at the end they open new discussion that GP is bug because "I have two GPs and level 18 hospital and queues are huge, please fix it".
This is the crux of the matter.
There seems to be a disconnect on the use of the word Spam. I have no problem with 2 or 3 Gold certs, as mentioned above I imagine them as Employee Performance Awards and the like. I actually like that I can have a couple. As in 2 or 3, not 20.
I have no problem with Plants as they have a radius; you can only make the surroundings so green before extra plants become redundant and don't help you. And the fact they have to be watered, so not even in the same post code for comparison.
There are 7 or 8 different posters, not one. One poster all over is Spam, 8 posters mixed and matched between other items is visual interest and decoration. We need more posters too if I'm being honest... More decoration in general. The game is fantastic with allowing so many variations in room builds, that needs to be encouraged and exploited as much as possible.
What I do dislike are 20 bookcases in the training room. Sorry, but that's a Library. I wouldn't mind having a small library in the hospital. Wouldn't mind a big library in the teaching hospital. But it's still a Library and not a Training Room.
A training room with 2 book cases, one of each poster and one of each of the skeleton and the anatomy guy looks good. Maybe a little more. Not really "bonus-ee" though. It would be nice to know that the anatomy guy gave me 5% not 1%. Raise the amount of Kudosh to get him, but make him a worthwhile investment, like an actual reward for putting the time and effort in. Make the bookcases 5% and 10%.
Make these items matter.
People gonna scream "gamey balance" and other assorted electron slurs, but stacking all of these things is what everyone (that doesn't play for asthetics) is doing now to achieve these kinds of numbers and higher already. Non starter for any argument. Raising the bar to get the items and limiting their use pleases both those that want the big bonus and those that want the pretty room.
There's too much ticky tacky single % bull fecal matter in all these bonuses. I'll take a 5%-5% Medicine Cabinet and one in the room over a wall of five 1%-1% any day of the week.
It looks cleaner, makes the items more important and in a game where pathing is really an issue it cuts down on the number of things that get in the doctor and patient pathways.
Cheers..!
That solution won't work for placing items outside of rooms, though, and I suspect that many people would (in a mindless attempt to make the prestige bar for each room go higher, because higher is better!) simply move to spamming different items in all the rooms, and complain that this makes the game less fun because it takes even more time than spamming gold star certificates.
But its worth a try, I think.
That's what makes me not mind plant spamming. Spam a ton of them and you pay monthly with extra janitor costs. Don't keep up the maintenance and they do nothing.